short and insightful writing about a long and complex history

Responsible Drinkers of the World Unite!

Welcome to the final (we’re sad to say) installment of guest blogger Henry Yeomans’ new series here on Points.Henry, a Lecturer in Criminology and Criminal Justice at the University of Leed’s School of Law, finishes off his series on changing conceptions of drink regulation in Britain by examining the implications of England’s newly-proposed minimum alcohol pricing.

PM Cameron to the English public: Pay up or dry up.

In March 2012, England and Wales reached something of a turning point regarding the regulation of alcohol. The Coalition Government released a new alcohol strategy that put forth the intention for a fixed, legal minimum price per unit of alcohol. Under these plans, it would be illegal for any retailer to sell an alcoholic beverage for less than the minimum unit price, which the strategy suggests may be initially set at 40p. The Scottish Government intends to introduce a minimum price of 45p per unit and the Northern Ireland Assembly has backed similar proposals, meaning cheap drink may soon be a hazy memory for Britons. But why is a minimum price considered necessary? The Prime Minister’s foreword to the England and Wales strategy explicitly states the rationale for this new policy: it is needed to tackle the “scourge of violence caused by binge drinking.” The Government considers binge drinking responsible for crime and violence which “drains resources in our hospitals, generates mayhem on our streets and spreads fear in our communities.” The Prime Minister is very clear that “this isn’t about stopping responsible drinking,” but is about targeting the small minority who drink to excess and cause problems for the rest of society. This strategy therefore reads like a rallying call; responsible drinkers are asked to unite behind tough pricing restrictions that will reform the behaviour of the irresponsible. This does not address the question, however, of where this idea of a minimum pricing comes from. Furthermore, is it simply a strategy for reducing binge drinking or will it have wider effects?

Targeting binge drinking through formal regulation is nothing new. New Labour adopted a fairly liberal line on licensing, famously removing statutory restrictions on opening times for licensed premises in 2005. But Tony Blair’s Government were dogged by accusations that these liberalising measures were fuelling binge drinking by young people and so worsening public drunkenness and disorder. The Blair Government responded by introducing a raft of new restrictions; alcohol-free zones, drink banning orders, and restrictions on drinks promotions were all efforts to clamp down on ‘irresponsible’ binge drinking. This regulatory approach, justified essentially as providing more freedom for the responsible and less for the irresponsible, echoed earlier government strategies. My last post described how, in the 1960s, licensing was somewhat liberalised while the regulation of some of the specific harmful consequences associated with drinking, including youth drunkenness, was enhanced. The Coalition Government’s current efforts to tackle binge drinking are, in some ways, simply an intensification of this older consequentialist preoccupation with the unacceptability or irresponsibility of youth drunkenness.

Sheffield, of the Sheffield Study

In some ways, however, minimum pricing represents a significant challenge to the consequentialist regulation that has been dominant since the 1960s. James Nicholls and Pekka Sulkunen, among others, have documented the development of “total consumption theory” (TCT) from the mid-twentieth century onwards. This school of thought was originally based on demographic research that suggested the best way to reduce alcohol-related harm was to reduce alcohol consumption amongst a whole population. In 2008, the Sheffield Study provided further support for this perspective by finding that minimum pricing, a measure which affects a whole population’s access to alcohol, would reduce a wide range of harms associated with alcohol, from throat cancer to unemployment. For advocates of TCT, this evidence implies that the distinction of “responsible” and “irresponsible” drinking is fatuous, as the reduction of all forms of drinking is linked to decreases in harm. All drinking, moderate and private as well as excessive and public, must become the legitimate object of governance.

The Alcohol Health Alliance (AHA), formed in 2007, has worked tirelessly to highlight the findings of the Sheffield Study and seek wider support for minimum pricing. Crucially, representatives of the AHA have repeatedly criticised the political preoccupation with young people binge drinking and argued that all forms of drinking are problematic for society. In 2009, Chief Medical Officer Liam Donaldson highlighted alcohol’s role in causing domestic violence, car accidents, sexual assault, suicide, and a host of serious health problems. In terms of ill health, he emphasised that “there is no safe alcohol limit.” Professor David Nutt, former member of the Advisory Council on the Misuse of Drugs, has similarly sought to highlight the toxic and addictive properties of even small amounts of alcohol. This viewpoint, in which youth drunkenness and public disorder are only a small part of Britain’s drink problem, has become increasingly influential and it is from this perspective, as a means to reduce general alcohol consumption, that minimum pricing has been developed and promoted as a policy in England and Wales. The Government, moreover, are certainly aware of this because, whilst in opposition, the Conservatives emphatically dismissed minimum pricing as an unfair punishment exacted on the responsible “majority of moderate drinkers.”

The issue at stake here is whether all drinking or just certain forms of drinking are problematic for society. My first blog detailed how drink debates during World War One illustrated that, in the early twentieth century, the temperance movement’s faith in the immorality of all drinking and the virtue of teetotalism was widely accepted, though not universally practised. My second blogshowed how the 1960s saw a shift away from forms of regulation that depicted all drinking as immoral, seeing the emergence of more concentrated regulation of certain types of drinking – that which was deemed to be demonstrably harmful in its consequences – instead. Although the current Government’s rhetoric is consistent with consequentialism, the growth of TCT and the imminence of minimum pricing suggest we are seeing a reversion back to the older, temperance-inspired faith in the inherently problematic nature of alcohol. Nowadays, this position tends to be justified in reference to medical, epidemiological, and demographic data, yet there is clear congruity with older discursive forces. This can be seen in the general problematisation of all forms of drinking, which was initially advanced by Victorian temperance groups, as well as the historical lineage of certain groups. The Alcohol Health Alliance (AHA) has been the primary agency involved in the campaign for minimum pricing and it includes prohibitionist groups, such as the Institute of Alcohol Studies, as well as medical organisations. The British temperance movement continues, therefore, to have some influence over the way in which alcohol is understood and regulated in England and Wales.

Outside of wartime, the levels of sobriety demanded by the temperance movement proved unpopular in this country. Alcohol has continued to be enjoyed by the majority of people in Britain and opinion polls suggest that minimum pricing is widely unpopular. The Government’s attempt to rally this majority of drinkers behind minimum pricing is therefore indicative of a rather confused strategy. There is an acute tension between a dominant consequentialism, which targets binge drinking as a specifically problematic behaviour popular with young people, and a medical or temperance-inspired project to reduce consumption in the whole population. It appears that the Government want to sound as if they are sticking to the former, while enacting policy devised to do the latter – a strange brew indeed. Naturally it is politically preferable for the Coalition to garner mass support for their policies, yet the political advantages may be eroded in the long term if apparently responsible drinkers find they have to either drink less or pay more. If the ‘responsible drinkers’ of Britain do indeed unite behind minimum pricing, they may soon find that they have more to lose than the social problems associated with binge drinking.

16 thoughts on “Responsible Drinkers of the World Unite!”

Enjoyed your post. I examined much the same drift toward regulation of total consumption in the U.S. policy context in this http://www.roizen.com/ron/postrepeal.htm, published in 2004 but actually written all the way back in 1997. I closed the essay with a question similar to the one you posed in the close of your Points essay, namely: Is this policy drift a return to the past? What’s interesting when I contrast my paper with your post however is that any sort of traction for a minimum pricing policy in the U.S. – despite the not dissimilar drift in elite thinking about alcohol – is hard to find. Last year, for instance, the voters of Washington State threw out their state’s monopoly on spirits sales and brought in privatization and free enterprise, partly in the hope of reducing alcohol prices. It’s interesting to speculate why this difference between the UK and the US. I don’t think late-night drunkenness and public disorder are or are seen as quite the problem in the US that they appear to represent in the UK. The US press now and then offers expose-like feature articles or TV news stories on “binge drinking” by youth, but nothing really ever seems to come of it. The occasional alcohol-related death, usually on a college campus, has a similarly momentary effect in the press. The UK either has a worse problem or its communitarian sensibility is stronger. One big difference between the two cultural settings is “pub culture.” The US has not, historically at least, developed the same sort of sociability nexus in bars that the UK enjoys in its crowded pubs. This may be a crucial factor, of course, as the UK’s pubocentric drinking culture concentrates the practice in a public place. Yet the UK minimum pricing initiative seems relatively less interested in pub culture or pub regulation than in minimum pricing. Yes? This of course may suggest the importance of the prospect of enhanced revenue in the motivation behind minimum pricing’s popularity in the UK and its halls of government. I wonder if you and other Points readers might be willing to speculate on the UK/US difference in this regard.

Ron,
American friends tell me that the minor temperance campaigns of the 1980s (eg. MADD) went some way to alleviating public concern by raising the drinking age to 21. It may be that US anti-alcohol groups are not yet as well co-ordinated as those in Britain?

If Henry Yeomans can provide the slightest bit of evidence to show that the Institute of Alcohol Studies is a prohibitionist body I’ll buy him a pint. (Nor is the International Organisation (not Order) of Good Templars a member of the Alcohol Health Alliance.)

The idea that all forms of alcohol (not just spirits) caused social problems and the idea that there is no safety in moderation did not really exist prior to the advent of teetotal temperance in the 1830s. I would therefore argue that most groups who espouse these ideas and use them as justification for government intervention can be associated with prohibitionist temperance thinking. This is particularly the case with the IAS, who were founded by the UK Alliance, and the Good Templars, who were revered in the nineteenth century as the shock troops of prohibitionism.

Generally, I prefer to call groups such as yours ‘neo-interventionist’ rather than ‘prohibitionist’, thus reflecting the fact that you do not explicitly advocate prohibition anymore. However, in the limited confines of a blog, I thought it conveyed the historical and discursive point I was making sufficently to refer to your group as ‘prohibitionist’.

Andrew,
Perhaps because they (you) were set up by, and receive 85% of their income from, the organisation formerly known as the United Kingdom Alliance for the Suppression of the Traffic in All Intoxicating Liquors?

Thanks for the comments Ron and for alerting me to your paper. I am not sure if this answers your questions, but here are my initial thoughts anyway.

I think there is definitely something in your point about pub culture. It is noteworthy that, in his foreword to the new alcohol strategy, David Cameron explicitly states that minimum pricing won’t hurt pubs. An already fairly controversial measure would no doubt be more divisive if it heaped further financial pressures on an already ailing (pun fully intended), much-loved British institution.

I don’t know that much about the situation in the US, but it is also worth saying that the Alcohol Health Alliance is extremely well organised. They have been consistently and vociferously arguing that price and availability determine levels of consumption for several years and garnered a fair amount of public attention. Is the public health lobby as cohesive and coordinated in the US?

I also suspect that a big difference is the NHS. My jaw dropped when I found out that Cameron had been converted to minimum pricing as, in every other aspect of government I can think of, he seems utterly committed to free market principles of competition and choice. However, if you recognise that accidents and ill-health resulting from alcohol incur costs to the NHS which taxpayers eventually foot, then it perhaps makes a bit more sense (- although, of course, opponents will rightly point out that alcohol raises huge revenue for the government too). I have a lot of sympathy with the argument that the ‘NHS card’ is simply a utilitarian justification for a much older moralistic concern. Yet when policy-makers are presented with figures for costs and potential savings that may be easy to ignore.

I am also not sure about comparative levels of binge drinking, but it is important to note that levels of alcohol consumption have been falling in Britain for some time (about 8-10 years). Binge drinkers, nevertheless, still make a useful target for politicians and they have enabled the Government to get the right-wing press to support a policy which restricts free trade.

Like I said, these are my initial thoughts. Let me know what you think.

Thanks for your good reply, Henry. A couple of quick thoughts backatcha:

1. Your point about Cameron operating contrary to type regarding minimum pricing is interesting. It reminds me of a similar — if reverse — US situation in the FDR administration after Repeal in 1933. Prohibition’s repeal stood out as one of the few places in FDR’s “New Deal” program where the federal government’s reach into the US society and economy was actually retreating rather than expanding. One result was that Repeal became a kind of catch-all for anti-FDR interests. I wonder if there might be a similar catch-all dynamic at work in UK politics, thus e.g. conflating the efforts of some unlikely bedfellows around minimum pricing. (On this interesting aspect of US post-Repeal politics see, esp.: Kyvig, David E., “Objection Sustained: Prohibition Repeal and the New Deal,” pp. 211-233 in Blocker, Jack S., Jr. (ed.), Alcohol, Reform and Society: The Liquor Issue in Social Context, Westport, Connecticut and London: Greenwood Press, 1979.)
2. Your point about the NHS deserves a lot of thought and exploration, IMHO. When I read Betsy Thom’s wonderful book on the history of British alcohol policy (Dealing With Drink, 1999) I get the slightly eerie feeling that everything sounds very much the same as the comparable US historial story re alcohol over the same period but also strangely different. I’ve wondered for a long time how much the presence of the NHS helps explain the differences. Of course the NHS both reflects a greater communitarian sensibility and, in turn, puts different sets of interests into play in the British situation. I hope I offend no one by saying that I’ve long wondered, for example, whether the British push for the efficacy of brief interventions or treatments for alcoholism, advocated by Edwards, reflected in part the backdrop of NHS’s budgetary concerns. I see that Laura Williamson has discussed the relative absence or under-attentiveness to alcoholism treaatment in the UK’s alcohol policy architecture in a couple of recent papers. How attractive minimum pricing must be with the NHS’s expense peering over an MP’s shoulder: It not only promises to reduce alcohol-related problems but it actually brings in revenue! How terrific is that!
3. I note with interest Cameron’s protective attitude toward pubs. Very interesting too. From afar.
Thanks again!

Derek Rutherford contributed an article about the United Kingdom Temperance Alliance that was published in the historical encyclopedia Alcohol and Temperance in Modern History (2003). To avoid heavy wartime taxation the UKA proposed the creation of the UKTA in 1941 as a non-political educational organization. In 1942 the Board of Trade approved this new tax-exempt organization. With separate governance, the UKTA and the UKA drifted apart. After 1985 the UKA no longer occupied offices in the Alliance House building. The UKTA funded various drink education organizations, notably beginning in 1983 the Institute of Alcohol Studies. In 2003 the UKTA became the Alliance House Foundation. (Presumably the IAS inherited the UKTA’s historical library.)

No, Henry, I’m afraid you’re even further away from a pint than you were before. And as for Christopher Snowdon, what can I say? The IAS was not founded by the United Kingdom Alliance and has never received a penny from it, let alone 85% of its income. The IAS is a separate body with its own objectives, which most certainly do not include prohibition. Anyone who is that interested can always look at the IAS web site, or alternatively that of the UK Charity Commission. RE IOGT, I take it Henry that you’ve now abandoned your claim that it is a member of the UK Alcohol Health Alliance.

On the more important question, I suppose it’s easy to understand why the specter of prohibition keeps appearing in the US, but I admit to being surprised that it is also regularly conjured up in the UK as well, a country which has never got within a million miles of it. I’m taken by Henry’s way of summoning the specter: “The idea that all forms of alcohol (not just spirits) caused social problems and the idea that there is no safety in moderation did not really exist prior to the advent of teetotal temperance in the 1830s. I would therefore argue that most groups who espouse these ideas and use them as justification for government intervention can be associated with prohibitionist temperance thinking.” On this basis, virtually all of us must be classed as prohibitionists, barring the few (all brewers possibly?) who are convinced that spirits alone are capable of causing social problems.

I’m sure the readers of this blog won’t thank me for explaining at length why I think Henry’s original post is somewhat wide of the mark, but perhaps i can add a couple of factual points regarding minimum unit pricing of alcohol (MUP). Ron Roizen suggests that it is the prospect of increased revenue that makes MUP attractive to the Government: hardly, as MUP is not a tax it will not directly raise any extra revenue, the higher prices benefiting not the government but the retailers (which is why bodies such as the Institute for Fiscal Studies object to it). As for the British pub, the actual point here is that drinking is now hugely less pub-centred in Britain than it was: most alcohol is now bought and consumed elsewhere, mainly from supermarkets for home consumption. So one of the attractions of MUP is that it should protect the pub trade from what it and others see as the unfair competition from the off-licensed retailers.

It’s a little troubling that you don’t know the history of your own organisation. The UK Alliance for the Suppression of the Trade in All Intoxicating Liquors was, as its name suggests, overtly prohibitionist. By the 1930s, Prohibition had failed in America and the UK Alliance’s leaders formed the UK Temperance Alliance (1942). In 1983, the UK Temperance Alliance formed the Institute of Alcohol Studies (IAS). Twenty years later, it changed its name again, to the Alliance House Foundation.

IAS’s latest accounts show a total income of £340,154, of which £292,428 came from the Alliance House Foundation = 85.9%.

Is the Alliance House Foundation prohibitionist? It’s true that many years have past since its earlier incarnations called for total suppression, but the AHF’s latest accounts describe its objective as: “To spread the principles of total abstinence from alcoholic drinks”. This is not direct evidence that the AHF, and the group it funds, are prohibitionist in intent (nor would I expect them to admit to it if they were), but they can certainly be described as a teetotallers descended from prohibitionists.

Andrew, I will get over the fact that you won’t buy me a pint but I would like to respond to your comments. I did not claim that anyone who says that beer as well as spirits causes social problems is a prohibitionist; I simply said that they can be “associated” with it by virtue of the discursive space they inhabit (in which all drinking is problematic, there is no safety in moderation and the solutions involve legislation which applies to everyone). I apply the label ‘prohibitionist’ more firmly to groups which have organisational links to prohibitionist groups. In terms of the point about US/UK, the British temperance movement had a subtle yet fairly significant impact over the way in which alcohol is understood and regulated in this country. I would direct you to some other work I have done for a fuller exploration of this: http://soc.sagepub.com/content/45/1/38.abstract?rss=1 .

In general, I think you have latched onto a rather small point in the original post and ignored the wider argument I was making. The main thrust of my piece seeks to highlight that the Government is advocating a TCT policy but using consequentialist justifications. It appears to be caught between two different ways of understanding and regulating drink (one of which has discursive affinities with prohibitionist temperance). These points stand, regardless of disputes about the origins and aims of IAS.

[This comment’s been in moderation for days so I will try again without the links]

Andrew,

It’s a little troubling that you don’t know the history of your own organisation. The UK Alliance for the Suppression of the Trade in All Intoxicating Liquors was, as its name suggests, overtly prohibitionist. By the 1930s, Prohibition had failed in America and the UK Alliance’s leaders formed the UK Temperance Alliance (1942). In 1983, the UK Temperance Alliance formed the Institute of Alcohol Studies (IAS). Twenty years later, it changed its name again, to the Alliance House Foundation.

IAS’s latest accounts show a total income of £340,154, of which £292,428 came from the Alliance House Foundation = 85.9%.

Is the Alliance House Foundation prohibitionist? It’s true that many years have past since its earlier incarnations called for total suppression, but the AHF’s latest accounts describe its objective as: “To spread the principles of total abstinence from alcoholic drinks”. This is not direct evidence that the AHF, and the group it funds, are prohibitionist in intent (nor would I expect them to admit to it if they were), but they can certainly be described as a teetotallers descended from prohibitionists.

After much thought I came to the conclusion that to be legal it could not be at a level high enough to work. And if high enough to work on a proportion of higher level hazardous drinkers and lower level harmful drinkers ( 35-60 units per week in men) it would A) have a disproportionate effect on lower income groups (see also Institute of fiscal studies commentary: http://www.ifs.org.uk/bns/bn124.pdf) B) produce a huge windfall profit for the industry mainly supermarkets who may use this largesse to increase advertising and reduce prices of product above the minimum unit price thus nullifying much of the effect (note that the average purchase price per unit in a recent Edinburgh study by Chick on 387 persons in treatment drinking an average of 197 units weekly was 43p).

If a legally acceptable level is proposed it will have minimal effect on 18-24 year olds (Sheffield model predicts a reduction of only 0.6% at 40p MUP) So much for stopping binge drinking in the young adults.